I have a hole under both breasts. Both are leaking yellow thick puss. Could my implants be exposed? necrosis? (photos)

I have a hole under both breasts. Both are leaking yellow thick puss. Could my implants be exposed? necrosis? I'm 4 weeks post op. I'm treating it 2x daily with SSD and applying gauze. Breasts are sore and the openings hurt. Please help! Thank you in advance!

Doctor Answers 12

I have a hole under both breasts. Both are leaking yellow thick puss. Could my implants be exposed? necrosis?

Thank you for your question. I recommend that you make an appointment with your plastic surgeon as soon as possible. They will be able to guide you through your convalescence and give you detailed instructions on wound care.

Conroe Plastic Surgeon
5.0 out of 5 stars 5 reviews

Post op complications following breast surgery

Follow up with your surgeon is going to be the best option for your problem  Wound care management is very important in your case.  It is impossible to give you advice without a physical exam.

Joseph W. Aguiar, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 7 reviews

Question post op

difficult to say without exam.  I always warn people that silvadene looks like pus after 12 hours. in my hands the implant would be under muscle or fascia so I would not be worried. but stay in  constant contact with your surgeon and make regular visits

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 64 reviews

I have a hole under both breasts. Both are leaking yellow thick puss. Could my implants be exposed? necrosis

This needs to be addressed with your surgeon asap. Please follow up with his/her office to discuss wound care and rule out infection. 

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Hole under the breast

Thank you for your question. You need to see your PS for evaluation. In pictures we can not tell about your implant exposure. You need a physical exam . 

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 30 reviews

Exposed Implants?

Thank you for your question.  I'm sorry this is happening to you.
This needs to be followed very closely by your plastic surgeon.  The implants aren't visible in the pictures, but a physical exam may reveal they are exposed.  It's unclear if that's pus, or if that's the SSD after it's been in the wound for a while.  Again, make sure your plastic surgeon is following you very closely.

Dr. Dan Krochmal
MAE Plastic Surgery
Northbrook, IL

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 23 reviews

Exposed implants

Yes your implants could be and are likely exposed and infected. You need to see your surgeon immediately like today to get that cleaned up and fixed.

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 32 reviews

Implant infection

A lift with an implant is controversial for two reasons.  First, when you perform a lift you are making everything tight and closing the wounds under tension.  It you add the expansive forces of the implant at the same time, you are fighting against yourself.  There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars.  In the worst case, the wounds will open.  So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant.  Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure.  Or a smaller implant than would be appropriate is used so as to decrease the expansive forces.  Either way, you are compromising the aesthetic outcome.  Often the outcome is so compromised that a second revision surgery is required.  If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation.  The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved. The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple).  By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple.  By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple.  If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop.  If the venous outflow stops, the arterial inflow is stopped.  If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies. Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation.  Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 135 reviews

Wound Issues

I'm sorry to hear about your difficulty. Your best course of action is to follow up in person with your Plastic Surgeon- ASAP and then continue with regular, in person assessment. Follow their instructions for wound care.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Hole Under Breasts - Could Implants Be Exposed?

Thank you for the photos. It appears from them that you have had a mastectomy (breast lift) in the past. It is fairly common to develop problems at the point where the vertical and horizontal incisions from a breast lift meet. When implants are inserted, all of the weight is put on this very spot. For this very reason, I have developed my own protocols for placing implants post-lift. There is a risk of the implants being exposed so I would highly recommend continued follow up with your surgeon so that the open wounds can be healed. Discuss with him/her your concerns, look into other options if this treatment does not appear to be improving things, and follow instructions carefully. SSD treatment can be messy and be confused with pus, but you don't want to take chances with infection or implant exposure so contact your surgeon.

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 70 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.